This is an interesting phenomenon seen in endocrinology. I will illustrate the same with a case
An elderly gentleman (non-diabetic) presented to the ER with recurrent hypoglycemia and hyponatremia
On evaluation, we found the patient suffered from Panhypopituarism leading to Adrenal insufficiency, Central hypothyroidism etc
This all this time that we were saving his life, we did not 'see' the patient . I mean really 'see' the patient
In the morning rounds today, when the patient was really better, I 'saw' the patient. Lo behold, the patient looked "Acromegaloid"
Here comes the time when THE ENDOCRINOLOGIST stops everything and tries to go back on time. Out comes the mobile phone with old photos. And then older photos. "Gosh, I am right. The patient DID have acromegaly some time in his life
But nature is great, it cured it without surgery ! An auto-hypophysectomy'
This curious term is used by Salam Ranabir and Manash P. Baruah in their review article on 'Pituitary apoplexy'
Basically, a highly vascular pituitary tumor bleeds, sometimes slowly to basically automatically cure the tumor and render the patient in a hypopit state only to be picked up by a keen endocrinologist at a later date. This ladies & gentleman's nature's own Pituitary surgeon.
This is perhaps a slow subclinical bleed
"Subclinical pituitary apoplexy” is widely used to describe pathological evidence of asymptomatic pituitary ischemia or hemorrhage" to quote Dr. Ranbir
The functional pituitary tumor like acromegaly naturally becomes non-functional leading to an automatic cure
🧵 Twitter Thread: The Surprising Case of a 6-Year-Old with Diabetes Mellitus
1/ Hey Twitterverse! 🌟 Today, I want to share an intriguing case that highlights the importance of considering all possibilities when diagnosing diabetes in children. Meet a 6-year-old boy who presented with newly diagnosed diabetes mellitus. #Diabetes #MODY #Pediatrics
2/ At first, we thought of the typical type 1 diabetes, which is quite common in children. So, we treated him accordingly with insulin therapy. But there was something that didn't quite add up. 🤔 #Type1Diabetes #InsulinTherapy
Oxytocin Deficiency in Patients with Diabetes Insipidus 🧪🩺
1/ Oxytocin deficiency in patients with diabetes insipidus (DI) has been investigated in a recent study published in The Lancet Diabetes & Endocrinology. Let's dive into the key findings and implications of this research!
2/ The study aimed to explore oxytocin deficiency in patients with arginine vasopressin deficiency (central DI) by using 3,4-methylenedioxymethamphetamine (MDMA), a potent activator of the central oxytocinergic system. This was a case-control study conducted at 🇨🇭
MC Thomas in his article argues that Type 2 Diabetes should be renamed the "CARAMEL Disease" (A 🧵)
What does CARAMEL stand for ?
CARAMEL stands for CArdiac, Renal, Adipo-Metabolic, Eye and Liver disease
His argument is that Type 2 diabetes is a mere manifestation of the "actual disease". So are the other manifestation of the CARAMEL acronym which all arise from the common soil... So that this common soil?
Diabetology.co.in is India's first and only evidenced based precision medicine & personalized medicine platform for diabetes made for the doctors and by the doctors.
The project is mentored by Dr. Arvind Gupta, a legend in this field from Jaipur.
We thank the RSSDI Research team, especially Dr. @banshisaboo and @dramitaol for giving us this opportunity.
1/5: 🩸 The Hemoglobin Glycation Index (HGI) compares a person’s actual HbA1c level to their predicted level based GMI (glucose management index) value from CGM
2/5: 📊 The HGI is calculated by subtracting the estimated HbA1c from the measured HbA1c. A high HGI suggests increased glycation rate, linked to microvascular complications in diabetes.
The Clarke Error Grid Analysis (EGA) is a tool developed in 1987 to assess the clinical accuracy of blood glucose meters by comparing their readings to reference values.
The grid breaks down a scatterplot of a reference glucose meter and an evaluated glucose meter into five regions:
Region A are those values within 20% of the reference sensor,